Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) Family Medicine, Primary Care, and Health Promotion Syllabus

Family Medicine, Primary Care, and Health Promotion syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Family Medicine, Primary Care, and Health Promotion in Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA), not a summary of it.

1. 1

   Preventive Medicine and Screening

   4 topics

   • Cancer Screening Guidelines
     • Breast, cervical, colorectal, lung screening
   • Immunization Schedules
     • Pediatric and adult vaccination
   • Cardiovascular and Metabolic Risk Reduction
     • Lipid and blood pressure screening
   • Lifestyle Counseling
     • Tobacco cessation and obesity management
2. 2

   Ambulatory and Chronic Disease Management

   4 topics

   • Chronic Disease Coordination
     • Multimorbidity and polypharmacy
   • Common Outpatient Complaints
     • Cough, fatigue, and dizziness
     • Joint pain and rash
   • Dermatologic Conditions
     • Eczema, psoriasis, and acne
     • Skin cancer recognition
   • Pain Management in Primary Care
     • Multimodal and osteopathic approaches
     • Opioid stewardship
3. 3

   Geriatrics and Palliative Care

   4 topics

   • Geriatric Syndromes
     • Falls, frailty, and polypharmacy
     • Delirium and cognitive decline
   • Functional Assessment
     • Activities of daily living evaluation
   • End-of-Life and Hospice Care
     • Symptom management and goals of care
   • Advance Care Planning
     • Advance directives and surrogate decisions
4. 4

   Population Health and Epidemiology

   4 topics

   • Epidemiologic Measures
     • Incidence, prevalence, and risk measures
   • Biostatistics and Study Design
     • Sensitivity, specificity, and predictive value
     • Trial design and bias
   • Public Health and Disease Prevention
     • Levels of prevention
     • Reportable diseases and surveillance
   • Social Determinants of Health
     • Health disparities and access to care

Family Medicine, Primary Care, and Health Promotion flashcards for Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA)

22 of 51 cards from the Family Medicine, Primary Care, and Health Promotion deck — real questions with worked answers.

1. At what age does the USPSTF recommend starting routine screening colonoscopy (or other CRC screening) for average-risk adults?

   Age 45 (Grade B); continue through age 75. Options include colonoscopy every 10 years, FIT annually, or FIT-DNA every 1-3 years.

2. What is the USPSTF recommendation for breast cancer screening mammography in average-risk women?

   Biennial (every 2 years) screening mammography for women aged 40-74.

3. How often should cervical cancer screening be done for women aged 21-29 vs 30-65?

   Ages 21-29: Pap cytology every 3 years. Ages 30-65: cytology every 3 years, OR hrHPV testing every 5 years, OR co-testing every 5 years.

4. Who qualifies for lung cancer screening with low-dose CT per USPSTF?

   Adults 50-80 years old with a 20 pack-year smoking history who currently smoke or quit within the past 15 years. Annual LDCT.

5. What is the recommended schedule for the routine infant DTaP series?

   DTaP at 2, 4, 6, and 15-18 months, with a booster at 4-6 years (5 doses total).

6. When is the Tdap booster recommended in adults, and what about during pregnancy?

   Tdap once in place of a Td booster, then Td/Tdap every 10 years. During EVERY pregnancy, give Tdap at 27-36 weeks gestation.

7. What is the recommended age and dosing for the shingles (recombinant zoster, RZV/Shingrix) vaccine?

   Two doses for adults aged 50 and older (and immunocompromised 19+), given 2-6 months apart.

8. Which pneumococcal vaccine schedule is recommended for adults 65 and older who are vaccine-naive?

   A single dose of PCV20 alone, OR PCV15 followed by PPSV23 at least 1 year later.

9. At what age is the first dose of MMR given, and when is the second?

   First dose at 12-15 months; second dose at 4-6 years.

10. What blood pressure threshold defines Stage 1 vs Stage 2 hypertension per the ACC/AHA 2017 guidelines?

    Stage 1: 130-139/80-89 mmHg. Stage 2: 140/90 mmHg or higher. Elevated: 120-129/<80.

11. What LDL-lowering benefit defines a high-intensity statin, and name two examples.

    High-intensity statins lower LDL by 50% or more. Examples: atorvastatin 40-80 mg and rosuvastatin 20-40 mg.

12. What 10-year ASCVD risk threshold generally warrants statin therapy in primary prevention (ages 40-75)?

    A 10-year ASCVD risk of 7.5% or higher favors statin therapy (intermediate risk 7.5-19.9%; high risk 20% or more).

13. What HbA1c level is diagnostic of diabetes mellitus, and what range defines prediabetes?

    Diabetes: HbA1c 6.5% or higher. Prediabetes: 5.7-6.4%.

14. What is the first-line pharmacologic agent for type 2 diabetes, and its key contraindication?

    Metformin; contraindicated when eGFR < 30 mL/min/1.73m2 due to lactic acidosis risk.

15. What are the '5 A's' framework for smoking cessation counseling?

    Ask, Advise, Assess, Assist, Arrange.

16. According to the Transtheoretical (Stages of Change) Model, name the five stages of behavior change in order.

    Precontemplation, Contemplation, Preparation, Action, Maintenance.

17. What is the recommended amount of moderate-intensity aerobic activity per week for adults?

    At least 150 minutes per week of moderate-intensity (or 75 minutes vigorous) aerobic activity, plus muscle-strengthening 2 days/week.

18. What counseling/screening interval does USPSTF recommend for unhealthy alcohol use, and what is a positive single-question screen?

    Screen all adults; brief behavioral counseling for risky drinkers. Positive single-item screen: 5+ drinks (men) or 4+ (women) in one day in the past year.

19. In chronic disease care coordination, what is the role of the 'medical home' (PCMH)?

    The Patient-Centered Medical Home provides comprehensive, coordinated, patient-centered, accessible care with a focus on quality and safety, centralizing management of chronic conditions.

20. What medication reconciliation step is most critical at care transitions to prevent adverse drug events?

    Comparing the patient's current full medication list against newly ordered medications at every transition (admission, transfer, discharge) to identify discrepancies.

21. What is the most common cause of acute cough lasting less than 3 weeks in outpatients?

    Viral upper respiratory infection (the common cold).

22. What is the Centor/McIsaac criteria used for, and name its components?

    Estimating likelihood of group A strep pharyngitis. Components: fever, tonsillar exudates, tender anterior cervical lymphadenopathy, absence of cough (+ age adjustment).

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